From the Guidelines
The duration for a blood transfusion should typically be around 4 hours, as recently found in a large survey of NICUs, with a median transfusion duration of 4 hours 1. The exact duration can vary depending on several factors, including the type and volume of blood product being transfused, the patient's condition, and their body size. For example, the volume of transfusion can range between 10 and 20 mL/kg, with some studies comparing different volumes such as 10 mL/kg, 15 mL/kg, and 20 mL/kg 1. However, it's essential to note that the transfusion duration is critical, and a controlled rate is necessary to avoid overwhelming the circulatory system and potentially causing fluid overload, heart failure, or pulmonary edema. Healthcare providers should monitor vital signs regularly during the transfusion, checking temperature, blood pressure, pulse, and respiratory rate before starting, 15 minutes after beginning, and periodically throughout the procedure to watch for any transfusion reactions. Some studies have assessed the association of transfusion volume with various clinical outcomes, but none of these trials was powered to assess relevant clinical outcomes such as mortality, long-term neurodevelopmental outcome, or substantial morbidities 1. Key factors to consider when determining the duration of a blood transfusion include:
- The type and volume of blood product being transfused
- The patient's condition and body size
- The need for monitoring vital signs during the transfusion
- The potential risks of transfusing too quickly, such as fluid overload or heart failure.
From the Research
Duration for Blood Transfusion
The duration for blood transfusion can vary depending on several factors, including the type of blood product being transfused, the patient's condition, and the transfusion protocol being followed.
- The study 2 found that the estimated effect of packed red blood cells with ≥ 21 days storage versus packed red blood cells with < 21 days storage for the outcome death from any cause was imprecise.
- Another study 3 found that blood heating is safe and causes hemolysis only in clinically negligible proportions at temperatures at or less than 43°C and even up to 45-46°C.
- A study 4 found that adding normal saline warmed to 45 C to units of packed red blood cells can warm them and increase blood flow in transfusions without significant hemolysis.
- The study 5 found that packed red blood cells are transfused to prevent tissue hypoxia, and the indication for transfusion is based on surrogate parameters, such as the hemoglobin concentration, in addition to clinical criteria.
- Another study 6 found that increasing the flow with an infusion pump increased haemolysis in RBCs from 0·2% to up to 2·1% at a flow rate of 600 ml/h regardless of the warming device used.
Factors Affecting Transfusion Duration
Several factors can affect the duration of blood transfusion, including: